Return to play refers to the point in recovery from an injury when a person is able to go back to playing sports or participate in an activity at a preinjury level.

No one likes to be sidelined with an injury. One of the goals of sports medicine is to try to get an athlete back into action as soon as possible. Returning too soon, before adequate healing or recovery has taken place, can put you at risk for reinjury and possibly an even longer down time.

With the right game plan for sports injuries—from early diagnosis and treatment to full functional rehabilitation—you can often safely accelerate your return to play.

A Lesson From the Pros

Why does it seem that professional athletes return to play so much faster than the average person or athlete? Professional athletes are usually in tremendous physical condition at the time of injury. This fitness level helps them in many ways. Studies have shown that good conditioning can not only prevent injuries, it can also lessen the severity of an injury and speed recovery.

Professional athletes also get prompt treatment when an injury occurs, and this lessens the acute phase of the injury. Early treatment means that there is less swelling, stiffness, and loss of muscle tone. In addition, professional athletes work extremely hard with a physical therapist and/or certified athletic trainer during their recovery.

Many professional athletes bring to their recovery what they bring to their sport—a positive attitude. Although you may not have access to the same resources that professional athletes have, you can harness the power of a positive attitude for your own benefit during recovery.

Phases

Recovery from an injury involves a series of logical steps from the time of the injury until you are able to be back on the field or court. Each step should be outlined and monitored by your physician and physical therapist.

During the acute phase of injury, the focus should be on minimizing swelling. This involves the RICE formula (Rest, Ice, Compression, and Elevation), along with a limitation of activities. Depending on the type and severity of your injury, treatment may also involve surgery, bracing, or even casting.

During the acute period, it is very important to maintain overall conditioning while the injury heals. Creative techniques can be used to safely work around the injury. For example, a runner with a leg injury can often run in water or use a stationary bicycle to maintain conditioning. Even if one leg is in a cast, the rest of the body can be exercised by performing strength-training exercises. Do not wait until your injury is healed to get back into shape.

In the next phase of recovery, you should work on regaining full motion and strength of the injured limb or joint. Your physician, therapist, or certified athletic trainer will outline an exact plan. For most injuries, gentle protective range-of-motion exercises can be started almost immediately. Muscle tone can be maintained with the use of electrical stimulation or simple strengthening exercises.

When strength returns to normal, functional drills can be started. For lower extremity injuries, this may include brisk walking, jumping rope, hopping, or light jogging. For upper extremity injuries, light throwing or easy ground strokes can be performed. Specific exercises for balance and agility can bring back the coordination that may have been lost in the injury.

Once you have progressed with motion, strength, endurance, and agility, and are tolerating functional drills, you can try higher levels of sport-specific movement patterns. This is monitored by your physical therapist or certified athletic trainer. You may find that tape, braces, or supports help during this transition time.

Only when you are practicing hard without significant difficulty, and the healing has progressed to the point where the likelihood of injury or harm is low, are you ready to return to play. During these final phases of recovery, you should be closely monitored. Special attention should be given to adequate warm up prior to the activity and icing after the activity.

A Word Of Caution

Following the rational progression of recovery not only lessens the chance of reinjury but also assures that you will be able to perform at your best when you return to play. All too often, athletes think they are ready to return as soon as the limp or the swelling subsides. They may feel good, but they are probably only 70% to 75% recovered. This invites reinjury.

Sports medicine experts are working on methods to help athletes get close to 100% recovery as quickly as safety allows. There is often tremendous pressure to get the athlete back as soon as possible, but the athlete's health and safety must be placed above all other concerns.

A systematic recovery plan is successfully used every day, at all levels of play, from the recreational athlete to the elite professional or Olympic athlete.

Copyright (c)1997 American Orthopaedic Society for Sports Medicine.

This Sports Tip is a joint endeavor of the American Orthopaedic Society for Sports Medicine and the National Athletic Trainers' Association to promote the health and safety of athletes.

AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS "Find an Orthopaedist" program on this website.